Background: There is a limited data examining the practice of using the
airway pressure release ventilation (APRV) mode for patients with acute
respiratory distress syndrome (ARDS) among respiratory therapists
(RTs).
Objectives: To evaluate the current practice and barriers when using
APRV mode in the management of patients with ARDS.
Methods: A cross-sectional online survey was disseminated between
November 2022 and April 2023 to RTs in Saudi Arabia. Descriptive
statistics were used to analyze the respondents’ characteristics.
Results: Overall, 802 RTs (male: 59.60%) completed the survey. 519
(64.71%) did not receive training on APRV mode. Moreover, 325 (40.52%) and 391 (48.75%) did not know if APRV was used at their
hospitals and if the mode was managed via protocol with ARDS patients.
Of the participants, 276 (34.41%) reported that plateau pressure should
be used as a target when setting P-high initially while 427 (53.24%)
believed that the initial P-low should be equal to 0 cmH2O. Moreover, 468
(58.36%) believed that the initial T-high should be between 4 and 6
seconds while 548 (68.33%) believed the initial T-low should be a set
time (between 0.4 and 0.8) seconds. The most appropriate intervention
to improve ventilation and oxygenation was to increase the P-high, which
was reported by 370 (46.14%) and 326 (40.65%) RTs, respectively.
Inadequate training was the most common barrier (678, 84.54%) to
APRV implementation.
Conclusion: APRV management varies between RTs which may be due to
inadequate training and the absence of protocols.